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Malignant-looking thyroid nodules with size reduction: core needle biopsy results
Ha Young Lee1,2, Jung Hwan Baek1, Eun Ju Ha1,3
1Department of Radiology and the Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ultrasonography (Seoul, Korea)
|May 18, 2016
Summary
Malignant-appearing thyroid nodules that shrink are typically benign, showing fibrosis and hemorrhage on biopsy. This understanding can help avoid unnecessary procedures.
Area of Science:
- Radiology
- Pathology
- Endocrinology
Background:
- Thyroid nodules with malignant ultrasonographic (US) features often raise concern.
- Size reduction in nodules can complicate diagnostic interpretation.
Purpose of the Study:
- To determine the malignancy status of thyroid nodules exhibiting malignant US features but demonstrating size reduction.
- To correlate US findings with histopathology in these specific nodules.
Main Methods:
- Retrospective analysis of 16 patients with thyroid nodules showing malignant US features and >20% size reduction.
- Core needle biopsy (CNB) performed on all nodules.
- Detailed analysis of US features including echogenicity, margin, calcifications, and rim characteristics.
- Histopathologic review of CNB specimens and correlation with US findings.
Main Results:
- All biopsied nodules were confirmed as benign.
- Common US findings included central hypoechogenicity and a peripheral isoechoic rim.
- Histopathology revealed fibrosis and hemorrhage in the hypoechoic areas and follicular cells in the isoechoic rim.
Conclusions:
- Thyroid nodules with malignant US features and size reduction are predominantly benign.
- Internal fibrosis and hemorrhage are key histopathologic findings.
- Recognizing these features can prevent unnecessary fine-needle aspiration or surgery.
